| Doctor Name: | TIFFANY J. VORDERSTRASSE |
| NPI Number: | 1003114802 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 2011006710 |
| Business Practice Address: | 105 Far West Dr. Ste. 105 St. Joseph, MO - 645063514 |
| Business Phone Number: | 8162718110 |
| Business Fax Number: | 8162718104 |
| Mailing Address: | 105 Far West Dr., Ste. 105 ST. JOSEPH |
| State: | MO |
| Postal Code: | 645063514 |
| Phone Number: | 8162718110 |
| Fax Number: | 8162718104 |
| NPI Enumeration Date: | 03/03/2011 |
| NPI Last Update Date: | 12/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2011006710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |